Anderson C B, Brennan D, Keller C, Goss J, Shenoy S, Burton K, Sicard G, Flye M W
Washington University School of Medicine, St. Louis, MO 63110.
Transplant Proc. 1995 Feb;27(1):991-4.
The induction of immunologic unresponsiveness to improve renal allograft survival was attempted in 163 patients by the pretransplant administration of donor-specific whole blood or buffy coat in conjunction with continuous Aza immunosuppression. All donor-recipient combinations were at least one-haplotype disparate, and 21 were two-haplotype disparate. Transient sensitization occurred in 2% and permanent sensitization in 7%. Over a 10-year period, the DST+Aza allograft survival rate is similar to the HLA-identical sibling transplants. The CMV sepsis rate was only 2%, and there were no lymphoproliferative neoplasms. The low rate of sensitization (7%) has permitted almost all patients to undergo eventual renal transplantation from the specific blood donor. This and the low rate of early rejection (3%) argues for a modification of the immunologic response.
通过移植前给予供体特异性全血或富含白细胞层并联合持续硫唑嘌呤免疫抑制，试图诱导免疫无反应性以提高肾移植存活率，该研究纳入了163例患者。所有供体-受体组合至少有一个单倍型不相配，21例为两个单倍型不相配。2%的患者发生短暂致敏，7%的患者发生永久致敏。在10年期间，DST+Aza肾移植存活率与 HLA 相同的同胞移植相似。巨细胞病毒败血症发生率仅为2%，且无淋巴增殖性肿瘤。致敏率低（7%）使得几乎所有患者最终都能接受来自特定献血者的肾移植。这一点以及早期排斥反应率低（3%）表明免疫反应发生了改变。
